Psychologists praised Filner’s stated intention to follow his two-week intensive treatment with continued therapy. But some questioned his plan to be briefed on city activities every morning and evening during those first 14 days.

“How is he going to do the city’s business and be unavailable during the day for two weeks?” Kalish asked. “Either the therapy is going to suffer or the city is going to suffer. You can’t serve two masters at once.”

Agreeing to seek treatment is a big step. But once the therapy begins, painful realities surface and new challenges arise.

“When they are self-referred, they don’t have a lot of motivation to stay because there are a lot of benefits to thinking of themselves as entitled and superior to other people,” said Reavis. “There isn’t a lot of benefit for them to develop a more realistic self-perception. You have to go back and uncover the sources (of the behavior), and sometimes when you do it’s too painful and they don’t want to do it.”

In the image-conscious world of politics, it’s hard for public officials to admit to any imperfection. So recovery can get lost in the spin cycle.

“Sometimes,” Kalish said, “they get their own personalities confused with the office they hold. When we are being respectful to the president, the governor, the mayor, we are respecting the person holding the office, not necessarily the person. Sometimes they forget about that.”

Case in point: In 2006, Donald Thompson, a former Oklahoma judge, was sentenced to four years in prison for repeatedly exposing himself and employing a penis pump while presiding over jury trials.

“Why people in power just feel free to exercise their libidos — that’s a mystery,” said Kent Mannis, senior editor for LawRoom. “It seems almost childish.”

Perhaps so, but some say it’s understandable. Sexual harassment “has to do with narcissism, a sense of grandiosity and power,” Kalish said. “And do we want people as leaders who are powerful, can make decisions and can influence others? Yes.”

But only within reason.

“I’ve been married to my wife 32 years,” Kalish said. “Early on, she gave me a valuable piece of advice: ‘Mark, when you start believing your own B.S., that’s when you’ll be in trouble.’ ”